Dva Renal Healthcare Inc

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

23320 Issued in NJ

Legal business name

DVA RENAL HEALTHCARE INC

Doing business as

Willingboro Dialysis

Practice address

230 Van Sciver Pkwy
Willingboro, NJ 08046-1131

Phone

(609) 871-3431

Fax

(609) 871-4122

NPI assigned

Jul 3, 2006

Last updated

Sep 19, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willingboro Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

DaVita Willingboro DialysisCCN 312584

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 31, 2005

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

18

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Dva Renal Healthcare Inc173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Dva Renal Healthcare Inc

  dba Cherry Hill Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cherry Hill, NJ
  • NPI 1255360384
  NPD tax ID

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Sarah Ahmad, M.D.

  • Nephrology Physician
  • Hainesport, NJ
  • NPI 1558725382

  Dialysis facility

  Care Compare affiliation Name & address match
• Varun Reddy, MD

  • Nephrology Physician
  • Hainesport, NJ
  • NPI 1508420696

  Dialysis facility

  Care Compare affiliation Name & address match
• Samir Nalin Shah, M.D.

  • Nephrology Physician
  • Hainesport, NJ
  • NPI 1659544716

  Dialysis facility

  Care Compare affiliation Name & address match
• Elliot Jay Suchin, M.D.

  • Nephrology Physician
  • Hainesport, NJ
  • NPI 1285683532

  Dialysis facility

  Care Compare affiliation Name & address match
• Myra Theresa Vargas, M.D.

  • Nephrology Physician
  • Hainesport, NJ
  • NPI 1285683573

  Dialysis facility

  Care Compare affiliation Name & address match
• Asheen Zariat, MD

  • Nephrology Physician
  • Hainesport, NJ
  • NPI 1598228462

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1346270782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 VAN SCIVER PKWY",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461131",
            "telephone_number": "609-871-3431",
            "fax_number": "609-871-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "23320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097560",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willingboro Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Willingboro Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dungarvin New Jersey, LLC - Clubhouse
• Dungarvin New Jersey, LLC - Gainscott
• Dungarvin New Jersey, LLC-Rancocas Day Program
• Durand, Inc.
• Dwayne E Dutton, RPH
• Sanietra Ecckles, B.A.
• Diana Eckert
• Cathy Edson, NP
• Marie Ann Edwards
• Pamela Edwards, LPN

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Willingboro, NJ
• Providers in Willingboro, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.